Management of Digital Tendon Avulsion at the Musculotendinous Junction of the Forearm: A Systematic Review

Collins, Jessica; Ishihara, Yoshihiro; Thoma, Achilleas

doi:10.1007/s11552-012-9402-8

Cited by 11 publications

(21 citation statements)

References 31 publications

(56 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…If serious damage is suspected in the examination, an immediate exploration could provide the chance to reconnect the two ends of a broken structure, with no additional dissection needed to expose and use other tendons [8].…”

Section: Discussionmentioning

confidence: 99%

“…Boyes et al [7] investigated 80 subcutaneous ruptures of the flexor tendons and reported that avulsion at the tendon insertion accounted for 62.8% of the studied cases, whereas avulsions at the MTJ accounted for only 5.1%. Although uncommon, tendon avulsion injuries at the MTJ could not be overlooked because treatment failures could result in an unrecognised compartment syndrome on a short-term basis when the tendons are avulsed from their muscle belly on the forearm or lumbricals on the hand, or in significant disability on a longterm basis [8]. Although methods of conservative management, such as splinting or wearing a brace, have occasionally been reported, most of the reported series involved cases of patients who underwent surgery or who had ruptures involv-ing the tendons [7,[9][10][11][12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

“…None of the injuries were open, and no patients underwent immediate surgery. Theoretically, direct repair of injured tendons to the muscle could produce the best chance to achieve good function because the procedure merely entails the reconnection of two ends of a broken structure, with no additional dissection needed to expose or use other tendons [8]. However, the direct repair of such injuries is not usually feasible owing to the local muscle pathology, such as shredded, edematous muscle tissues and variable muscle retraction degrees [15,20].…”

Section: Introductionmentioning

confidence: 99%

“…However, the direct repair of such injuries is not usually feasible owing to the local muscle pathology, such as shredded, edematous muscle tissues and variable muscle retraction degrees [15,20]. In avulsion amputations, reattachment of the tendon to its muscle is the most favoured form of treatment when the digit was replanted [8]. Stevanovic et al [4] reported the largest series of 17 patients who sustained traumatic amputations of the thumb with the tendons avulsed from the MTJ.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Could immediate treatment change the management method of digital tendon musculotendinous junction avulsion?: a systematic review

Park

2017

Yeungnam Univ J Med

View full text Add to dashboard Cite

Background:We conducted a systematic review of the literature to investigate the correlation between the interval to treatment and management of tendon avulsion ruptures in the musculotendinous junction (MTJ) of the forearm. Methods: A thorough literatures search for studies of tendon avulsion injuries at the forearm was conducted using PubMed, MEDLINE, CINAHL, and Cochrane databases in accordance with the PRISMA guidelines. In total, five case series and 15 case reports accounting for 87 injured tendons involving 60 patients were selected for the analysis. Results: Twenty-six patients had 44 tendon injuries associated with avulsion amputations, 31 patients had 38 tendon ruptures associated with closed avulsion injuries and three patients had five tendon ruptures associated with open avulsion injuries. Eighteen of the 49 (37%) patients were immediately treated for tendon ruptures and one of the 32 (3%) tendon ruptures treated via elective surgery was directly repaired. Additionally, 18 of the 30 (60%) tendons were directly repaired and 12 of the 30 (40%) tendons were transferred or side-to-side repaired in the immediately treated series. In contrast, one of the 28 (4%) tendon ruptures were directly repaired and 27 of the 28 (96%) tendons were transferred or side-to-side repaired in the electively treated series. Conclusion: In managing digital tendon avulsions at the MTJ, an immediate treatment could provide an opportunity to repair the ruptured tendon directly to the muscle.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Could immediate treatment change the management method of digital tendon musculotendinous junction avulsion?: a systematic review

Park

2017

Yeungnam Univ J Med

View full text Add to dashboard Cite

show abstract

“…

AbstractClosed traumatic rupture of tendons at the musculotendinous junction occurs when there is a sudden longitudinal pull of the tendon against a contracting muscle as in resisted extension or flexion of a finger [1]. The weakest point in the whole musculotendinous unit is however at the distal insertion point of the tendon into bone as described by Boyes [2].

…”

mentioning

confidence: 99%

Closed Traumatic Avulsion of Extensor Digitorium Communis and Extensor Indicis Proprius of Index Finger at the Musculotendinous Junction

Sefeane¹,

Aa²,

Mshuqwana³

2016

Journal of Case Reports and Studies

View full text Add to dashboard Cite

Closed traumatic rupture of tendons at the musculotendinous junction occurs when there is a sudden longitudinal pull of the tendon against a contracting muscle as in resisted extension or flexion of a finger [1]. The weakest point in the whole musculotendinous unit is however at the distal insertion point of the tendon into bone as described by Boyes [2]. When considering the extensor tendons in isolation, the most closed ruptures occur at the insertion of the tendon on the distal phalanx or the attachment of the central slip at the base of the middle phalanx.Introduction: Closed traumatic rupture of extensor tendons of the fingers at the musculotendinous is rare. In fact the common sites of a closed rupture are distal attachment at the distal phalanx as well as at the attachment of the central slip at the base of the middle phalanx. The diagnosis of these injuries at the latter sites is straightforward. Case presentation: We present a 19 year-old right hand dominant motor mechanic male patient who sustained injury of his left forearm while swinging from gymnastic bars. He reports that while swinging, he felt a violent snap at the dorsum of his left forearm while his body swung down from a height. He thinks that the grip of the left hand did not release in time following the downward swing of his body. He presented few days after the injury complaining of pain, swelling and inability to actively extend the index finger. On surgical exploration, it was documented that both the extensor digitorium of the index as well as the extensor indicis proprius were torn at their musculotendinous junctions. Both tendons were sutured side to side before the resultant joined tendon was sutured to the extensor tendon of the middle finger. A below-elbow volar slab was applied for 6 weeks followed by hand therapy. The patient was seen for some time and came back only once for follow-up. At 8 months postoperatively, he was back to his work with full recovery demonstrating isolated index finger extension. Discussion: Closed traumatic rupture of the extensor tendons at the musculotendinous junction is very rare. This case serves to highlight, the peculiar mechanism of injury; the violent snap that results from the rupture and the presented clinical picture. Like this case, if surgery is done in time, a good outcome is to be expected when side-to-side suturing of the two tendons is done and the resultant joined tendon is sutured to the adjacent middle finger extensor tendon.

show abstract

Man With Finger Injury

Pršić

McGregor

2016

Annals of Emergency Medicine

View full text Add to dashboard Cite

Management of Digital Tendon Avulsion at the Musculotendinous Junction of the Forearm: A Systematic Review

Cited by 11 publications

References 31 publications

Could immediate treatment change the management method of digital tendon musculotendinous junction avulsion?: a systematic review

Could immediate treatment change the management method of digital tendon musculotendinous junction avulsion?: a systematic review

Closed Traumatic Avulsion of Extensor Digitorium Communis and Extensor Indicis Proprius of Index Finger at the Musculotendinous Junction

Man With Finger Injury

Contact Info

Product

Resources

About